Brain & Body: Chronic Illness & ADHD

I was diagnosed with type 1 diabetes (T1D) when I was 6, almost 7 years old. I don't mind spilling the beans that I'm 35, so you can do the math (please don't make me, because #dyscalculia).

I don’t need to go into detail about what managing T1D involves, but just know that it requires an additional 180–300 decisions every single day. Most of these decisions happen without conscious thought, but subconsciously, it’s always running in the background. And these aren’t “apple or orange?” decisions. They’re “If I do this, will it make me violently unwell, hospitalize me, or kill me?” or “If I don't do this, will it make me violently unwell, hospitalize me, or kill me?”

I don't say this for sympathy. Like I said, I have had this for 28 years. It is second nature to me, and to be honest, I don't actually remember living any other way.

I share it to demonstrate the level of baseline overwhelm most people with T1, and many other chronic illnesses, carry with them every day, often without even realizing it.

Managing chronic illness is difficult, but managing chronic illness with the additional complexities of being neurodivergent is incredibly challenging. Additionally, there is an increased incidence rate of long-term, chronic illnesses in neurodivergent people, for a variety of physiological reasons.

Going most of those years with undiagnosed ADHD made my treatment… difficult, to say the least. People will often ask me, “OMG! How did you do it?!” And the answer to that question was simple and felt shameful. I didn’t.

I missed appointments and wouldn’t go to the doctor for years at a time. I didn’t check my blood sugar. I skipped insulin (more to come on that) and/or regularly forgot to take it. I ended up in the hospital a lot, but somehow, luckily, avoided going into DKA and needing a luxury suite in the ICU for a few days.

And then… it happened. My ADHD diagnosis. Honestly, one of the best days of my life.

Somehow, I had no idea and was completely shocked when I got the diagnosis, but once I started to connect the dots, things clicked. All of a sudden, the answer to “Why do these things only happen to you?” or “Why are you like this?” became ADHD.

I don't think it is an exaggeration to say that being diagnosed saved my life. If not my life, it saved my eyesight, my kidneys, my heart, my feet, etc.

Once I had the proper support and medication, it was like stepping into a new world. For the first time in my entire life, I was able to keep my blood sugar graph looking like a gentle river instead of a jagged mountain range. For once, I didn't feel nauseous all the time.

People who are both neurodivergent and chronically ill need additional support, mentorship, and encouragement to stay engaged with their treatment plans and still live full lives. That’s not a failure. It’s reality.

Supporting people who are both neurodivergent and chronically ill cannot fall solely on the individual; it requires awareness and action from healthcare providers and employers who have the capacity to make that support real.

When neurodivergent people with chronic illness are given the right support, from healthcare providers and employers alike, the difference isn’t marginal: it’s life-altering.

If you build an environment where people feel safe to disclose and self-advocate for reasonable adjustments (AKA psychological safety), you build an environment that is better for everyone.

Alex Knight

President & Neurodiversity Specialist

Iron & Ember Consulting Written without AI